Improving Patient Safety and Clinical Workflow: System Integration through Medical Device Interoperability

5.12.2009  SPEAKER: Julian Goldman, MD, Medical Director of Biomedical Engineering, Partners HealthCare; Principal Anesthesiologist, MGH "Operating Room of the Future"; CIMIT Director of Interoperability; Founder, Medical Device "Plug-and-Play" Interoperability Program MODERATOR: Peter Szolovits, PhD, Professor of Computer Science and Engineering, MIT Department of Electrical Engineering and Computer Science; Professor of Health Sciences and Technology, Harvard/MIT Division of Health Sciences and Technology; Head, Clinical Decision-Making Group, MIT Computer Science and Artificial Intelligence Laboratory

Forum Summary

Proponents of interoperability in the hospital setting hope to use technology to increase the error resistance of medical systems.  The importance of effectively transferring information from one medical device to another is underscored by the large number of patient transfers that occur every day.  Concerns related to interoperability also play a major role in efforts to prepare for major outbreaks of disease.  On a local level, automation and “smart” alarms make it easier for a small number of care providers to manage a large number of patients, and on a national level, transferring information is critical to resource allocation and to population surveillance.  A number of groups representing many components of the healthcare systems are currently pushing for increased interoperability in medicine.

The National Science Foundation (NSF) recently sponsored a workshop to promote research related to cyber-physical systems.  The goal of this research is to integrate computation, communication, and information storage with the monitoring and control of physical and engineering systems. 

Hospitals are also beginning to push for interoperable systems.  Experts from Massachusetts General Hospital (MGH), Partners HealthCare, Johns Hopkins, and Kaiser Permanente recently gathered together to write sample language pertaining to interoperability for hospitals to use in contracts with vendors.  Their report, known as the Medical Device Free Interoperability Requirements for the Enterprise (MD FIRE), is meant to help other institutions obtain appropriately interoperable systems from vendors.  Although the report was only released one year ago, at least one large purchasing association is already interested in the suggested language.

Standards are also being created to address issues related to interoperability.  One standard is known as the Integrated Clinical Environment (ICE).  This standard provides examples of adverse events caused by systems lacking interoperability, and its goal is to improve patient care by reducing the frequency of medical errors.

As these three initiatives illustrate, interested parties are pushing for interoperability from many angles.  Clinicians and hospital systems are beginning to call for interoperability, and so are agencies involved in hospital regulation and the formation industry standards.  If interoperability is to be achieved, expectations must change along with healthcare technology.  

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